Bacterial Infections In GYN

Question 1

UTI bacteria

Answer 1

E. coli

Staph saprophyticus, Proteus, Pseudomonas, Klebsiella, Enterobacter

Question 2

UTI treatment

Answer 2

Trimethoprim+/-Sulfa (Bactrim) (TMP/SMX) 3D, Nitrofurantoin monohydrate (Macrobid) 7D,

Pyelo Bactrim 14 D
- inpatient AMP+GENT

Question 3

When to repeat antibiotic dosing

Surgical site ppx

Answer 3

every 4 hours or 1500 cc of blood loss

cefazolin

or gent+clinda/Gent+Flagyl/Levoquin

Question 4

PPX for HSG

Answer 4

Doxycycline for 5 days

Question 5

Does Hysteroscopy need Abx PPX

Answer 5

No

Question 6

Mechanisms of preps

Answer 6

Chorhexidine- disrupts cell membrane

ETOH- denatures protein

Question 7

Cuff Cellulitis

Answer 7

Amox/Clav (augmentin)

Gent+ Clinda

Question 8

Wound Infection

Answer 8

Cephalexin, Bactrim, Clinda

Question 9

Abdominal Abscess

Answer 9

AMP/GENT/Clinda

Question 10

Recurrent MRSA infections

Answer 10

decolonization
Mupirocin oint. BIDx5 nares
 Chlorhexidine wash daily +/- oral abx

Question 11

Necrotizing fasciitis

Answer 11

Type I: polymicrobial (55-75%)
 Immunocompromised, post-op
Type II: Staph, Strep (A&B), Clostridia, Klebsiella
 Post-op, trauma, healthy
Debridement(s)
Abx (Vancomycin, linezolid), hyperbaric O2, IVIg
 Physiologic support

Question 12

Treatment for TTS

Answer 12

usually S. Aureus or Strep A

Clindamycin
 Suppresses toxin formation
Vancomycin (MRSA)
Supportive therapy, IVIg may help

Question 13

Management of Sepsis

Answer 13

First 6 hrs: maintain CVP 8-12mmHg, MAP>65, UOP>0.5mL/kg/hr

Antibiotic coverage (pip/tazo+gent+vanc), narrow when able

Protect respiration, restore perfusion, maintain access, control
source

Pressors, steroids, insulin/glucose, blood, nutrition, DVT prevention

Question 14

When to biopsy Bartholin’s Duct Abscess

Answer 14

> 40 years old

Question 15

Mastitis

Answer 15

S.Aureus and S. Epidermidis

Dicloxacillin 500 mg daily 14 days

If not improving Gent/Clinda or Bactrim

Abcessess- Drained